Description
Background:
Sickle cell disease (SCD) is among the most prevalent and under-addressed genetic non-communicable diseases (NCDs) in Kenya. It is associated with recurring pain crises, strokes, and frequent hospitalizations, placing immense strain on patients and the health system. Automated red blood cell exchange (aRBCx) presents clinical advantages over conventional therapies by reducing complications such as iron overload and extending crisis-free intervals. Despite its benefits, aRBCx remains underutilized in Kenya, with limited data on its implementation in African settings. This study explored the policy, financing, and implementation landscape of aRBCx in Kenya to identify barriers, enablers, and strategic opportunities for scale-up.
Methods:
A qualitative case study design was used, involving 18 semi-structured interviews with key stakeholders: hematologists, medical officers, pediatricians, representatives from patient advocacy groups, healthcare insurers, and apheresis technology providers. Thematic analysis was conducted to assess cost, clinical utility, system readiness, and policy alignment.
Results:
Five key barriers to aRBCx uptake emerged: (1) high cost (~KES 250,000 per session) with limited SHA coverage; (2) restricted availability and infrastructure, with only three private facilities offering the service; (3) significant blood supply requirements (7–8 units/session) amid shortages; (4) limited provider and patient awareness; and (5) policy gaps, including unclear eligibility guidelines. However, notable enablers were identified: clear clinical benefits (fewer crises, reduced stroke risk), potential long-term cost savings, increasing policy advocacy, growing provider training, and improved patient outcomes. Insurers showed interest if supported by cost-effectiveness data. Stakeholder momentum is increasing toward broader integration of aRBCx in SCD care.
Conclusion:
aRBCx is a promising innovation for SCD care in Kenya, but cost, infrastructure, and policy limitations hinder its adoption. Addressing these barriers through expanded insurance coverage, clinical training, and clear national guidelines could improve access, reduce complications and hospitalizations, and strengthen Kenya’s broader NCD response.
| Country | Kenya |
|---|---|
| Organization | Private Sector |
| Received a Grant? | No |
